Computed Tomography in the Diagnosis of Deep-Neck Infections

Holt, G. Richard; McManus, Kieran; Newman, Richard K.; Potter, Janet L.; Tinsley, Philippa

doi:10.1001/archotol.1982.00790590015005

Cited by 90 publications

(15 citation statements)

References 9 publications

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“…Similar to previous studies, our results suggest that CT scans were highly sensitive in diagnosing an abscess (81%) but not very specific (67%) [3,[5][6][7]. Criteria for determining an abscess that have been used by other authors include low density numbers, the presence of air or fluid, and rim enhancement [3,[5][6][7][8]. At our institution, we prefer to use an overall assessment taking in consideration the attenuation of the collection, the presence of a complete enhancing rim and the size of the collection.…”

Section: Discussionsupporting

confidence: 83%

Retropharyngeal and parapharyngeal infections in children: the Toronto experience

Daya

Papsin

et al. 2005

International Journal of Pediatric Otorhinolaryngology

131

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Section: Discussionsupporting

confidence: 83%

Retropharyngeal and parapharyngeal infections in children: the Toronto experience

Daya

Papsin

et al. 2005

International Journal of Pediatric Otorhinolaryngology

131

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“…The differential diagnosis between abscess and cellulitis is an important issue in management because of the possibility of serious complications without appropriate management. Holt et al [10] reported that CT scans had 100% accuracy in the diagnosis of deep neck abscesses. Miller et al [11] conducted a prospective, blinded comparison of clinical examination and CT scan in deep neck infection.…”

Section: Discussionmentioning

confidence: 99%

Parapharyngeal Abscess: Comprehensive Management Protocol

Oh¹,

Kim²,

Kim³

2006

ORL

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Parapharyngeal infections are rare, but they cause serious morbidity and mortality. Therefore, until now, the recommended treatment of parapharyngeal abscess has been early open surgical drainage. The purpose of this study is to review the clinical course and outcome of treatment in parapharyngeal abscess according to method of treatment. A prospective study was designed for parapharyngeal abscess in patients admitted for deep neck infection. During an 8-year period, from June 1994 to January 2003, 34 patients were enrolled. All had contrast-enhanced computed tomography (CT) imaging and confirmation of an abscess in the parapharyngeal space. All patients were treated with intravenous antibiotics. We treated 19 cases (conservative group) with antibiotics only or needle aspiration and 15 (surgical group) with intraoral or external drainage. The mean duration of hospitalization was 8.2 days in the conservative group and 11.6 days in the surgical group. There was no complication except mediastinitis in 1 case of the conservative group. Because of severe dyspnea, 5 patients required tracheotomy. Neck CT scan is a useful diagnostic tool to detect and establish the treatment plan of parapharyngeal abscess. Parapharyngeal abscess may, in some cases, respond to antibiotics, become localized to the parapharyngeal space and be treated conservatively with no need for early open surgical drainage.

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“…In the 1980s, CT of the neck better delineated the soft tissues of the neck, helping to define the presence of an abscess. In fact, because of the reported nearperfect accuracy of CT in differentiating abscesses from phlegmons in some early reports of small case series in the 1980s and early 1990s, 19,20 physicians began to rely heavily on CECT results to dictate their management.…”

Section: Commentmentioning

confidence: 99%